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Medical Files
Cheaper medicines a healing balm

By Rafael Castillo, MD
Philippine Daily Inquirer
First Posted 01:01:00 07/19/2008

Filed Under: Health, Medicines

MANILA, Philippines?Almost six weeks ago, President Macapagal-Arroyo affixed her signature which made the cheaper medicines bill a law. The entire nation now eagerly awaits the implementation of this new law.

The signing of the law by the President was done at the Laguna Provincial Hospital in Sta. Cruz, Laguna, which is somehow symbolic of what the real spirit of this law is and who the real beneficiaries are.

It should translate into medicines getting within reach of the average Filipino, those who persevere in waiting for their turns in the long queues in government hospitals; and not those who go to five-star medical centers in chauffer-driven limousines.

Not an easy process

For a bill that was tagged by PGMA as urgent or a priority measure, it begs a good explanation why it took our solons both in the House and Senate several years to approve their respective versions and agree on a unified bill. In fact, the bill was bypassed by the 13th Congress due to lack of time and quorum.

?It?s not an easy process because for very important and sometimes controversial bills, medyo madugo pagkasunduan ang isang measure (it?s very difficult to agree on a measure),? explains Sen. Pia Cayetano, chair of the Senate committee on health and demography and principal coauthor of SB 1658, during her keynote speech in this year?s Philippine College of Physicians? annual convention.

The ?bloody? process in finalizing the unified form of the bill was due to disagreements among the Senate and House conferees on some salient provisions of the two bills. These were the ?generics only? prescription by doctors, and the creation of a ?regulatory board.?

Physicians are glad that the senator-conferees stood their ground in not agreeing to the House version mandating doctors to prescribe only in generics format without brand names. They heeded the advice of former health secretaries, officers of medical organizations and other healthcare professionals, including pharmacists who still defer to the prescribing physicians the choice of specific brands they trust can effectively treat the patent?s medical condition.

Patient?s interest at heart

?I want to be sure that when they [patients] leave their doctor?s office, they know what their doctors specifically want them to have,? Senator Cayetano says.

Doctors generally still have their patient?s best interest at heart and will not prescribe a medicine which they know the patient cannot afford, especially with the availability of equally effective and cheaper alternatives.

The ?regulatory board? provision was also not deemed necessary since prices will automatically be regulated by competition in the free market. If there are available cheaper but equally effective versions of expensive branded medicines, the likely scenario is that the prices of these branded medicines will be reduced to remain competitive.

This has already been shown in recent years with the reduction of the prices of medicines for hypertension, diabetes and cholesterol problems when local companies came out with ?branded generics? at half the price or less. The cheaper brands showed equal efficacy as the original but more expensive brands.

A lower cost of medicine is however meaningless if the quality of these drugs could not be assured. Hence, the Bureau of Food and Drugs or BFAD will play a critical role in ensuring this. A valid concern is the capability of the BFAD to undertake this important role.

To address this concern, a provision of the law allows BFAD to retain its income, approximately P150 million annually, which was previously remitted to the National Treasury. This can serve as an upgrading fund to purchase equipment and hire more people to do their mandated task of ensuring the quality of medicines made available to the public at a lower price.

The Department of Health has been tasked to come out with implementing rules and regulations or IRRs within 120 days after signing of the law. Hopefully, these IRRs, which should embody the sentiments of all the law?s stakeholders, can truly enhance the effective implementation of the law, and not complicate it as what has happened to some of our unimplementable laws.

During this time of rising prices of gas, electricity, rent and food, a reduced cost of needed medicines can be a soothing and healing balm.



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